N.Y. county EMS director warns of decreased services

“In many cases ... it’s taking greater than 30 minutes, sometimes 40 minutes plus, to get an ambulance to members within our communities," Ann Smith said

By Abraham Kenmore
Watertown Daily Times

CANTON, N.Y. — North Country Regional EMS Program Director Ann Smith delivered a dreary view of emergency medical services in St. Lawrence County to county legislators during a joint Operations and Services Committee meeting.

"What is your expectation when you call 911?" Ms. Smith asked the legislators. "That you're going to receive an ambulance, right? In a timely manner."

Ms. Smith's organization is contracted by the Fort Drum Regional Health Planning Organization to provide health care services, and she serves as an EMT in the county, so she has firsthand experience with the challenges of providing emergency medical care. With fewer resources, she says there are growing delays in how long it takes an ambulance to reach a patient.

"Time is heart muscle, time is brain tissue, and time can also be the determining factor of whether you live or die," Ms. Smith said. "In many cases ... it's taking greater than 30 minutes, sometimes 40 minutes plus, to get an ambulance to members within our communities."

Ms. Smith said a number of factors have led to a steady decline in EMS services in the county, which were now causing significant delays. Unlike fire protection and police, it is not something municipalities are required to provide.

"The number of EMS calls far outweigh the number of fire calls," Ms. Smith said.

The result is that EMS services rely heavily on volunteers, something New York state has a shortage of, according to Ms. Smith. The state ranks 48th out of 51 states and territories for volunteers. Those who do volunteer face heavy regulation for both personal certification and organizationally, as well as difficulty being reimbursed for their services.

"Most agencies are not compliant with all the regulations, not intentionally, but because they are so onerous," Ms. Smith said. For those who are interested in becoming certified to volunteer as EMS providers, only SUNY Canton provides the training in county. The total result is a shortage of paramedics.

"We have 19 in this whole county, and only 10 who are actively providing care," Ms. Smith said.

Ms. Smith brought several suggestions for actions the county could take to help address the issue, including supporting state legislation to allow insurance to pay EMS providers directly, rather than reimbursing patients who may or may not pay for their ambulance ride, make EMS an essential service, which would open up grant and municipal funding options, and encourage increases in Medicare and Medicaid funding. Finally, she asked that the legislators create a task force to examine the issue in the county.

Legislators asked a number of questions about the issue. Legislature Chairman Kevin D. Acres asked about what might cause the low number of volunteers in New York County, and how many hours it took to become certified—around 170, according to Ms. Smith.

"So that's almost like a month of someone's time," Mr. Acres said. "That's like 30 days out of their lives. So I can see why people would have to be really committed to really want to do this."

Larry D. Denesha, R-DeKalb, expressed his own experience of being a volunteer firefighter and the issues with being reimbursed, as well as saying that ambulance services were being overused for unnecessary calls—something Ms. Smith agreed was an issue.

"I wish I had an answer, I think it's something we need to work on," he said.

Mr. Acres also asked if Ms. Smith could provide some guidelines for the task force to consider solutions that have worked in other places.

"On the 16, we're having a work session here for ideas we want to take to the state legislative body," Mr. Acres said. "If you can get us something before that ... we can promote those ideas."

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